4/20 KT PMPS 240 QUESTION ANSWERED! TY! Re: bounce

[Squeaky and KT (GA)]

Good morning World! Yesterday

+10.5 - 278
AMPS 249 - WHAT? Derz fuds in der....

Looks like this bounce is breaking during a DAYTIME cycle! WooHoo! It usually happens overnight leaving him handing me something like a 56 at pm+10...knows it makes me worry for a bit.

QUESTION - What is the mechanism in the body that suddenly takes away the glucose to 'clear the bounce'? It doesn't just slowly 'dissolve', it suddenly just disappears.

Harley - (lymphoma? drooler) is doing WONDERFUL! Just AMAZINGLY WONDERFUL! The lymph nodes have shrunk everywhere - I have to really feel to find one of the ones on his neck that was a softball last weekend!!! I'm still stuffing him with high dose empirical antibiotic. I'm taking him to vet next week and having them run tests to tell me if this really IS cancer or if they jumped to conclusions due to the terribly swollen lymph nodes. There's something called "Lymphadenopathy" that physically looks the same but IS NOT CANCER. IT is treated with antibiotics - THIS is responding to antibiotics. One of the things I noticed this last weekend when we thought we were losing him - the swelling was other places besides the lymph nodes such as completely thru his lips....THAT looked like infection instead! Am I going to learn that we've all been thru this emotional hell for an INFECTION? One part of me will be very angry, the other part of me will be dancin' in the streets!

I've got blooms on my tomato plants! Also have one cucumber vine that's doing quite well, the others aren't so pretty, hope they start doing better.... :roll:

Thoughts and prayers today for all needing them especially Karen/Smokey....

HUGS to all!!!!

 

[Melissa & Tarragon]

Re: 4/20 KT AMPS 249 QUESTION Please-bounce clearing

Nice bounce breaking action KT! I have no idea on your question but someone definitely will.

Great news on Harley! I have been thinking about you. A friend here at work has a dog that was diagnosed this week with lymphoma. Wouldn't that be something if it was just an infection and not cancer? I would dance right along with you, after we kicked the vet in the you know what. Hugs to you Lyresa. You are a great bean!

My tomato plants are doing really well and all my beans and black eyed peas are up. Woohoo! I usually have to back plant the beans but they all took this year. It must be all this glorious rain we have been getting. You have cucumber vines already? Mine are just starting to vine.

Hope you have a great great day!

 

[Roni and Moonie]

Re: 4/20 KT AMPS 249 QUESTION Please-bounce clearing

Please read this: Somogyi rebound aka "Somogyi's phenomenon" is a common phenomenon in pet diabetes : When blood sugar levels drop too far or too fast, the animal will defensively dump stored glucose from the liver into their bloodstream, resulting in high blood sugar.
This is rebound or bounce--It is a Natural reaction to lower numbers, and will usually clear within 72 hours.
Hope this helps Lyresa--
I AM SO AMAZED BY HARLEY!!!! I have prayed for him as I do for all the babies on here--No not a religious fanatic, but Man, our animals need some heavenly help!! And it works--Look At this news!!!
But just figure this, How Many Humans are misdiagnosed by Drs?? LOADS!!!! So, Thank God Harley is doing better--So Happy for you--Have a good Good day!!!! Hugs from us! :mrgreen:

 

[Ann & Tess GA]

Re: 4/20 KT AMPS 249 QUESTION Please-bounce clearing

Nice to see the bounce clearing in the daytime. I'm not sure, but i think it is more that the liver stops panicking and stops putting out the sugars and hormones that caused the bounce in the first place.

Great news on Harley? Why was he on ABs if they thought he had cancer? I think they should have held off on the C word if they thought it could be something else. :YMHUG:

 

[Roni and Moonie]

Re: 4/20 KT AMPS 249 QUESTION Please-bounce clearing

That quote about rebound is directly from the Sticky on the main page here in LL-- about Lantus & Levemir-Insulin Depot--Hope it explains it for you!!

 

[Sienne and Gabby (GA)]

Re: 4/20 KT AMPS 249 QUESTION Please-bounce clearing

When a bounce occurs, the liver releases a stored form of glucose along with counterregulatory hormones (cortisol for example is one of those hormones). Both glucose and the hormones cause the increase in BG levels. It can take up to 72 hours for those products to clear the system. As they are being metabolized, numbers eventually begin to come down.

 

[Squeaky and KT (GA)]

Re: 4/20 KT AMPS 249 ANOTHER QUESTION Please-bounce

When a bounce occurs, the liver releases a stored form of glucose along with counterregulatory hormones (cortisol for example is one of those hormones). Both glucose and the hormones cause the increase in BG levels. It can take up to 72 hours for those products to clear the system. As they are being metabolized, numbers eventually begin to come down.

OK, that makes sense - that leaves me with ANOTHER QUESTION: Why does it happen so suddenly like a tank running out of fuel for example rather than sort of slowly sliding down? Do the hormones released only last for a certain length of time such as the 72 hours?

I understand what's happening to create the bounce and what it is but this above is the part I still can't get a picture of in my head.

+6 - 177!!! ALRIGHT!!! BLUE!!!! This is an example of what I'm trying to understand the triggering of this:

pm+10.5 - 278
AMPS 249
+6 - 177

THANKS GUYS!!!!

 

[Ella & Rusty & Stu(GA)]

Re: 4/20 KT AMPS 249 +6-177 ANOTHER QUESTION Please-boun

Hey Lyresa, FD is unpredictable. Things happen because they happen! So be happy that the bounce clears fast when it decides to clear!

What fantastic news about Harley! You and DH must be thrilled that he is doing so well. We continue to send vines and prayers for him to have a complete recovery.

We have little green things coming up in the garden, under last fall's leaves. I think spring is finally here (antijinx!)

Have a great evening with that master bounce-clearer and your happy drooler (and all the rest of the gang, too).

Hugs,

Ella & Rusty

 

[Anne & Zener GA]

Re: 4/20 KT AMPS 249 +6-177 ANOTHER QUESTION Please-boun

Good questions about bounces. They don't make any sense to me either. But then I think, oh, it's a cat. KT is doing great.

Yay for Harley!!! That is fabulous news. I hope he continues to improve and the antibiotics do their thing.
Liz

 

[Squeaky and KT (GA)]

Re: 4/20 KT AMPS 249 +6-177 ANOTHER QUESTION Please-boun

Of course, after I ask the questions above, he just hands me a nice curve for the day instead of continuing downward. It's very nice but doesn't make a very good example. He ate at +10 so can't test for another hour...

My grandfather always said I was born asking 'why'.... :roll: This bounce clearing thing really confuses me. If there's something I can read elsewhere, please point me in the right direction.

THANKS EVERYONE!!!! BIG HUG!!

 

[Sienne and Gabby (GA)]

Re: 4/20 KT AMPS 249 +6-177 ANOTHER QUESTION Please-boun

Asking "why" is good. It helps not only your understanding but it makes me think about your question.

+6 - 177!!! ALRIGHT!!! BLUE!!!! This is an example of what I'm trying to understand the triggering of this:

pm+10.5 - 278
AMPS 249
+6 - 177

I'm not sure I'm fully understanding your question so if my reply is off target, let me know. First observation, there's a 100 point drop from PM +10.5 to AM +6 (and a 72 point drop from AMPS to +6). If you look at the decrease per hour, it's between 10 - 13 points per hour. That's not that big of a drop. In particular, if you look at the pattern after AMPS, it's 10 points per hour after you've given insulin. That looks like a pretty gentle slide into blue.

The counterregulatory hormones do wear off at different rates. I also suspect there are other factors that are in play -- like whether a cat's pancreas is producing it's own insulin or if your cat is getting used to spending time in better numbers -- which may effect how quickly the bounce clears.

 

[Squeaky and KT (GA)]

Re: 4/20 KT AMPS 249 +6-177 ANOTHER QUESTION Please-boun

Asking "why" is good. It helps not only your understanding but it makes me think about your question.
.....
The counterregulatory hormones do wear off at different rates. I also suspect there are other factors that are in play -- like whether a cat's pancreas is producing it's own insulin or if your cat is getting used to spending time in better numbers -- which may effect how quickly the bounce clears.

THAT'S the answer I was looking for Sienne! So if I go to a scientific definition of diabetes and find those counterregulatory hormones then look THEM up, maybe I'll be able to makes sense of them.... :roll:

And yes, today's slide was very nice and VERY unlike what he usually does...it's only because he read this...

PMPS 240

THANK YOU!!!!

 

[Marje and Gracie]

Re: 4/20 KT AMPS 249 +6-177 ANOTHER QUESTION Please-boun

In reality, Somogyi has not been documented as occuring in cats.....

Here's some really great information that Sienne posted on one of our condos when we were brand spanking new newbies after a vet told me that Gracie was in serious Somogyi and I was killing her:

The topic of Somogyi came up some time before you joined the Board. Both Jill and I did a lot of lit searching. I have access to both a medical and veterinary library system. For a theory that has so many people convinced that it is a factor in human as well as in feline diabetes, there is an amazingly small amount of research on the topic. The earliest paper by Michael Somogyi, is from the 1930s and was not published in a widely recognized medical journal (i.e., it was in the Weekly Bulletin of the St. Louis Medical Society). Note that this was a report based on 5 human subjects and urine glucose, not blood glucose was measured. More recent reports note that Somogyi's observations have not been reliably reproduced under controlled conditions.

Gale, EA., et al., Lancet, 1980, pp 279-282, In search of the Somogyi effect wrote:
Although some patients had a very rapid fluctuation from hypoglycaemia to hyperglycaemia, we found no evidence that changes in counterregulatory hormone levels were responsible.The preceding interval of hypoglycemia was often prolonged, which implied defective homeostasis, and the difference between the patients with apparent rebound and those without could not be explained in terms of circulating levels of cortisol, growth hormone, or glucagon. Other workers have noted very variable changes in growth-hormone and cortisol levels after acute hypoglycsemia in unstable diabetics. We did not measure catecholamines and cannot rule out the possibility that they were partly responsible for the difference between our groups. However, the evidence presented here suggests that free insulin is the major factor involved.
The bold is mine. It points out that there is no evidence for what the vet is suggesting about "stress" hormones (i.e., cortisol).

In addition to the dearth of empirical research, there is even less that pertains to cats and none that addresses Somogyi phenomenon in the use of Lantus. Given that the presence of Somogyi is believed to be associated with doses that are raised in too large of an increment, it is surprising that this IM vet would not be an enthusiastic supporter of the Queensland/Rand tight regulation protocol. (FYI - there is another TR protocol and the vet may have assumed this was the one you were referring to.)

This is a link to info on Chronic Somogyi Rebound on Wiki. I would draw your attention to the section on Controversy:

"Although this theory is well known among clinicians and individuals with diabetes, there is little scientific evidence to support it. Clinical studies indicate that a high fasting glucose in the morning is more likely because the insulin given on the previous evening fails to last long enough.[5] Recent studies using continuous glucose monitoring show that a high glucose in the morning is not preceded by a low glucose during the night.[6] Furthermore, many individuals with hypoglycemic episodes during the night fail to wake due to a failure of release of epinephrine during nocturnal hypoglycemia.[7] Thus, Somogyi's theory is not assured and may be refuted."

This information pertains to humans, not cats. However, the phenomenon was based on humans and extrapolated to felines so I'm going to presume the issues with the paucity as well as quality of the research are the same.

And I am praying hard that Harley just has an infection!!! You are amazing!!